You Can’t Have Both Crohn’s Disease And Ulcerative Colitis
There. I said it.
You cant. It is not possible to have both Crohns Disease and ulcerative colitis. For some reason over the last decade this has become a very hot topic of debate amongst patients in the IBD community so Id like to address this misconception, help you understand where it comes from, and provide you with accurate information to help you better understand IBD and why it isnt possible for one person to have both Crohns disease and ulcerative colitis.
The Interactive Influences Of Age And Dose: When Infected With A Small Dose Of Map Adults Develop Ulcerative Colitis Relatively Soon After Being Infected While Children Develop Crohn’s Disease After A Long Latency Period
An examination of another family with both diseases suggests why some people get ulcerative colitis and others get Crohn’s disease when infected with the same microorganism. This family had been living in a section of Germany with water that “was poorly controlled hygienically.” The mother, the adult, developed ulcerative colitis only 6 months after living in the area. Her two children developed Crohn’s disease, one 4 years after living in the area and the other 5 years after.
As countries become westernized, meaning specifically the introduction of MAP-contaminated beef and dairy foods and the corresponding environmental pollution by MAP-infested beef and dairy cattle feces, their populations first develop ulcerative colitis and then again after a delay of several years develop Crohn’s disease:
As societies become more “westernized” or industrialized…ulcerative colitis emerges, but the incidence of Crohn’s disease remains low. Over time, Crohn’s disease emerges, and its incidence ultimately matches that of ulcerative colitis .
Getting Proper Oral Care
Skipping the dentist is not uncommon in adults, especially when there are so many other factors at work. People with IBD already see various physicians on a regular basis and may have a significant financial burden to go along with it. Getting teeth cleaned twice a year or taking care of other oral problems tends to get pushed down the list of priorities, which is understandable.
However, like many aspects of healthcare, appropriate preventive care is going to be the most important factor in avoiding future problems. Brushing and flossing twice a day is recommended oral care for most adults, but people with IBD should ask their dentists if other daily care is necessary.
Finding a dentist that has experience with patients who have IBD can take time. It may be worth asking a gastroenterologist for a recommendation to a local dental practice that has experience with patients with IBD or other chronic illnesses. Some dental procedures may call for the use of antibiotics or non-steroidal anti-inflammatory drugs and a gastroenterologist should be kept in the loop when these drugs are used. This is because antibiotics and NSAIDs have both been shown to cause problems for some people with IBD, such as diarrhea or even a flare-up.
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What Are Symptoms Of Crohn’s Disease And Ulcerative Colitis
Symptoms of Crohn’s disease and ulcerative colitis that are similar include:
Crohns disease can also cause symptoms in the body outside the GI tract, including:
Additional symptoms of ulcerative colitis may include:
For both conditions, relapses, when inflammation and symptoms worsen can occur, followed by periods of remission that can last months to years when symptoms subside.
What Procedures And Tests Diagnose Crohn’s Disease And Ulcerative Colitis
Doctors diagnose ulcerative colitis by endoscopy . During this procedure the doctor can see and take pictures of the patients abnormal gut mucosa , and the presence of continuous disease . Other blood tests and imaging tests like CT scan or MRI are used, but these tests are not definitive.
Doctors use the same procedures and tests to diagnose Crohns disease. However, they also use small bowel studies, colonoscopy, and upper GI endoscopy to identify the abnormal gut mucosa that usually occur in multiple areas anywhere in the intestinal tract. These areas are not continuous, but are separated by normal areas of intestinal mucosa that distinguish them from ulcerative colitis lesions.
As with Crohns disease, nutrition is important if you have ulcerative colitis because symptoms of diarrhea and bleeding can lead to dehydration, electrolyte imbalance, and loss of nutrients. It may be necessary to take nutritional supplements if your symptoms do not allow you to eat a nutritionally balanced diet. Talk to your health-care professional about what supplements to take.
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Ibd Medications And Kidney Problems
The medications you take for IBD can sometimes cause issues with kidney function. Mesalamine and immunosuppressive medications like cyclosporine can sometimes change kidney function by causing the blood vessels in the kidneys to constrict, but this effect is very rare.
However, studies have found that other medications, such as aminosalicylates, methotrexate, and azathioprine, do not negatively affect estimated glomerular filtration rate , which is used to measure kidney function.
What Are The Complications Of Ulcerative Colitis
Direct complications of UC can include:
- Intestinal blockage and/or tearing
- Abnormal narrowing of the colon
- Slow growth and weight gain
- In the long term, people with UC have a higher rate of colon cancer
Complications outside of the intestine, also called extra-intestinal manifestations, can include:
- Skin: Unusual skin rashes
- Joints: Pain and swelling of joints ankylosing spondylitis
- Eyes: Inflammation of different parts of the eye
- Mouth: Oral sores , which may range in severity from painless to severe and are usually recurrent
- Bone: Reduced bone mineral density
- Blood: Anemia
- Blood vessels: Increased risk of blood clotting, especially in the setting of active disease and/or after surgery
- Liver: Inflammation of the liver may occur from IBD or from the associated conditions of autoimmune hepatitis and primary sclerosing cholangitis
- Kidney: Increased risk of kidney stones
- Psychological: UC is often associated with depression and/or anxiety, perhaps due to some combination of inflammation, anemia, malnutrition, and the stress of painful or disruptive symptoms
- Sleep: Increased risk of sleep disorders
There also are a wide range of complications that can be caused by different UC treatments, including drug allergies and side effects. It is sometimes difficult to know whether it is the UC itself or the medications that are the cause of a symptom or problem. If you are concerned that your child is experiencing a complication or a side effect, be sure to discuss it with your doctor.
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What Causes Ulcerative Colitis
However, there are cases where the diagnosis of one form of IBD over the other is very difficult. At times, a final diagnosis is possible only after an event during the course of the disease or its treatment makes the form of IBD readily apparent.
Patients with IBD may be very confused as to the differences between these diseases. As with any chronic condition, education is an important tool to become an active participant in one’s own treatment plan.
If your diagnosis isn’t firm, don’t panic. In some people, it can take time to determine if the IBD is more like Crohn’s disease or more like ulcerative colitis. In about 5-20% of cases, people are diagnosed as having indeterminate colitis .
IBD is becoming increasingly treatable and there are now many medications in the arsenal that are helping people with all forms get greater control over their disease. The main differences between ulcerative colitis and Crohn’s disease are described below.
Smoking can worsen condition
What Are The Complications Of Crohns Disease
Crohns disease can lead to serious complications, including:
- Abscesses: Infected pus-filled pockets form in the digestive tract or abdomen.
- Anal fissures: Small tears in the anus can cause pain, itching and bleeding.
- Bowel obstructions: Scar tissue from inflammation, fistulas or a narrowed intestine can block the bowel partially or completely. Waste matter and gases build up. A blockage in the small bowel or large bowel requires surgery.
- Colon cancer: Crohns disease in the large intestine increases the risk of colon cancer.
- Fistulas: IBD can cause abnormal tunnel-like openings, called fistulas, to form in the intestinal walls. These fistulas sometimes become infected.
- Malnutrition: Chronic diarrhea can make it hard for your body to absorb nutrients. One common problem in people with Crohns disease is a lack of iron. Too little iron can lead to anemia when your organs cant get enough oxygen.
- Ulcers: Open sores called ulcers can form in your mouth, stomach or rectum.
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Questions For Your Doctor
Could any condition other than my disease be causing my symptoms?What tests do I need to take to get to the root of my symptoms?How often should I get these tests done? Should it be during the time of a flare-up or on a routine basis?What parts of my digestive system are affected?How will we know if my medication needs to be adjusted?When should I expect to see results?What are the potential side effects of the medication? What should I do if I notice them?What should I do if the symptoms return?If I cannot see my doctor right away, are there any over-the-counter medication options that can assist with my prescribed medication? If so, which ones?What symptoms are considered an emergency?How will I know if I need a different medication?
Should I change my diet or take nutritional supplements? If so, can my doctor recom- mend a dietitian or any specific nutritional supplements?Do I need to make any other lifestyle changes?When should I come back for a follow-up appointment?
What Are The Signs And Symptoms Of Ulcerative Colitis
People with UC may have some or all of these symptoms:
- Abdominal pain: The pain may be in the lower left part of the abdomen or more generalized around the abdomen. This pain may be persistent, severe, and could possibly wake your child from sleep.
- Diarrhea: Passage of watery stool or frequent stool that is different from your childs normal pattern. It could be mild to severe and may frequently wake your child from sleep.
- Tenesmus: This is the sensation of fullness in the rectum, which may lead a person to feel that they still need to use the toilet even after they have passed a bowel movement.
- Blood in the stool
- Joint pain
- Skin changes, which may look like sores, bruises, or large hives on the shins
- Constipation: Although not typical, some people with UC have constipation, although this is usually in combination with other symptoms.
Other symptoms, referred to as extra-intestinal manifestations, occur outside the digestive tract. These are detailed in the complications section below.
Your primary care physician will perform an initial evaluation if you are concerned that your child has UC. Ask your doctor for referral to a pediatric gastroenterologist if your child has blood in the stool, persistent diarrhea, persistent abdominal pain, weight loss, or slow growth.
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The Influence Of Sex: Boys Develop Crohn’s Disease More Easily Than Girls While Men Develop Ulcerative Colitis And Women Develop Crohn’s Disease When Infected With Map
It is commonly known that infant males are more prone to infectious diseases than infant females, probably due to weaker immune systems . This weaker immune response might cause boys to develop Crohn’s disease more often than ulcerative colitis when infected with MAP, because they probably have a weaker immune response to the MAP organism. It has been postulated that Crohn’s disease is not an autoimmune disease, a disease of excessive or over reactive immunity, but an immune deficiency disease . Individuals with Crohn’s disease have a less active response to the MAP organism, in contrast with individuals with ulcerative colitis, who have a more active response, as proposed above.
In contrast to children, adult females seem slightly but consistently more likely to develop Crohn’s disease and adult males to develop ulcerative colitis when infected with MAP. While purely speculative, this difference might be due to the differing effects of testosterone versus estrogen on blood and lymphatic vessels, to the greater effects of smoking on females than males , or to the increase in oral contraceptive use, with its known vascular complications .
Colitis And Crohns Disease And Incontinence
Incontinence can be a problem for some suffering from Colitis and Crohns. Both conditions can cause diarrhoea and also an urgent need to go to the toilet. This can lead to accidents which can leave you feeling embarrassed and uncomfortable. To avoid accidents, or if they cannot be avoided, to help you deal with them, it is a good idea to always be prepared.
When you are at home, accidents should be relatively easy for you to manage. Make sure you have the necessary equipment in the bathroom to hand should you have an accident, such as disposable tissues which are a lot more hygienic to clean yourself with and less likely to irritate the skin. Air fresheners are also useful to disguise any smells.
If you are concerned about having an accident when you are out and about, keep some spare, clean underwear in your bag and a packet of baby wipes to help you stay fresh and comfortable. Keep a plastic bag handy so you can dispose of any soiled items too. It is also a good idea to know where the nearest toilets are located.
B& BC can provide a Just Cant Wait toilet card which could help you gain access to a toilet when out shopping or socialising. The card states that the card holder has a medical condition and may require the urgent use of a toilet. If you would like to apply for a toilet card online or order one by phone, please visit our toilet card page for more information.
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Complications Of Ulcerative Colitis
A small number of people with colitis can develop inflammation in other parts of the body, such as the liver, skin, joints and eyes.
Regular monitoring by a gastroenterologist, as well as colonoscopies, may help prevent complications from developing. But medications, including steroids and drugs designed to prevent inflammation and occasionally surgery may be needed.
Osteoporosis can develop as a side effect of long-term corticosteroid use.
Cases of marked inflammation caused by UC can also lead to:
- nutritional deficiencies
- heavy bleeding due to deep ulcers
- perforation of the bowel
- problems with the bile ducts, affecting the liver
- fulminant colitis and toxic megacolon, conditions that cause the bowel to stop working
In the long-term, UC is associated with an increased risk of developing bowel cancer. After 10 years the risk of bowel cancer is 1 in 50, and after 20 years it increases to 1 in 12. This risk can be decreased by maintaining a healthy diet, exercising and avoiding alcohol and smoking.
The Difference Between Ulcerative Colitis And Crohn’s Disease
Crohn’s disease is also an inflammatory bowel disease . The 2 diseases affect the digestive tract differently:
- Ulcerative colitis only affects the large bowel , and inflammation is only in the surface layers of the bowel lining. It causes ulcers to form in the lining of the bowel.
- Crohn’s disease can affect any part of the digestive tract, from the mouth to the anus , but usually just the last section of the small bowel and/or the colon. Inflammation can extend into the entire thickness of the bowel wall.
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Infectious Colitis: Causes Symptoms And Treatment Tips
The term infectious colitis sounds awful, and it can be. Infectious colitis is inflammation of the main part of the large intestine and can lead to sudden lower abdominal pain. In some cases, the pain can be severe.While inflammation is a common medical term and may not seem all that serious, the reality is that when left untreated, it can lead to complications and has the potential to be deadly.
Uc Linked To Missing Gut Microbes
Scientists from Stanford University School of Medicine recently carried out a study that looked at the microbes present in a persons GI tract. They found that people living with UC had a deficiency in a particular family of bacteria that help prevent inflammation.
The study raised questions about supplementing or replacing the missing bacteria as part of treatment for UC. Several of the same researchers are currently involved in a phase 2 clinical trial looking at the use of a supplement known as ursodeoxycholic acid to see whether it can reduce inflammation and improve quality of life.
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Nori Health Raises New Investment In Fight For Better Chronic Bowel Disease Careyour Browser Indicates If You’ve Visited This Link
There is a 30% difference in quality of life between people with chronic conditions, such as Crohn’s disease and UlcerativeColitis, and healthy individuals. According to startup Nori Health, this gap can be bridged by providing digital support to patients in addition to traditional care.
How Are Gallstones Disease Treated
If the gallstones are not causing symptoms, you may not need treatment.3 Your health care provider may just want to follow-up with you periodically.
When treatment is necessary, the usual treatment is surgery to remove the gallbladder.2 This procedure is called cholecystectomy. Your gallbladder is not an essential organ, so you can live normally without it. The surgery can be done as a minimally invasive procedure or an open procedure. Both procedures have the same complication rates. You may be able to go home sooner and recover more quickly after the minimally invasive approach.3
If you cannot have surgery, other treatments include:2,3
- Dissolving the gallstones with medicine .
- Shock wave therapy to crush the gallstone .
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